Education is an integral part of the nursing process. It is a proposeful activity, systematic training, which leads to gain knowledge and skills by means of a special process of learning. The aim of this work was to find out, whether nurses provide patients with education within the nursing process and whether patients feel that this education is sufficient enough to keep an optimal level of their health. All hypotheses I have set were confirmed. Apparently, from the results of the survey, health-educational activity, which is in plenary powers of nurses, is done by nurses themselves for the most part, but in some cases also the doctor took part in this activity. Although most of the asked expressed satisfaction with the information provided, there were still clients who were not satisfied with the number of information both theoretical and practical. In most cases, clients said that the instructions, which had been given to them by the nurse within the educational activity, were very significant for improving their health. Cooperation between a nurse and a client is based on a good communication between both parts. The result of this understanding is a situation when a client obeys the instructions given. From results it is obvious that all clients tried hard to keep professional recommendation provided by the nurse and reach the goal this way.Nowadays, the nurse, who is thanks to her learning within the area of education highly professional, puts an emphasis on mutual cooperation not only with the client but also with his family. The nurse respects client´s individual needs and tries to make him participace actively in his health care.

This diploma thesis is focused on the influence of teaching students of the Faculty of Health and Social Studies of the University of South Bohemia in Czech Budejovice on a mentor nurse´s attitude to nursing care provision. In the first chapter of the theoretical section the term nurse is introduced, and it is dealt with her duties, roles, attitudes, it is explained who a mentor nurse is and what topics a pilot certified course contains. The next four chapters are focused on a supervisor´s personality, supervision issues, teachers and their non-traditional roles and the didactic skills of a mentor. The description of a mentor´s didactic skills is divided into education, student diagnostics, teaching goals and classroom practices. The sixth part deals with student clinical practice mentors, their role in clinical practice, assessment and feedback and mentorship as an advancement of nurses´ work. The seventh chapter of the theoretical section introduces the issue of communication as an integral part of nursing practice teaching and in the last section we have focused on the issue of evidence-based nursing. The aim of this thesis was to investigate the impact of nursing practice teaching on a mentor nurse´s attitude to nursing care provision and students´ evaluation of a mentor nurse´s achievements in nursing care provision. The outcomes of the quantitative research, conducted by using a questionnaire method, confirm the hypothesis 1 suggesting that students regard mentor nurses´ nursing procedures as standards for their future practice. We can also confirm the hypothesis 3 suggesting that students believe that a mentor nurse considers the correct information registration into nursing documentation as necessary, and also the hypothesis 2 suggesting that students believe that a mentor nurse can communicate more effectively than other staff nurses was confirmed. Mentor nurses´ attitudes to nursing care provision were identified by using qualitative investigation by asking research questions. Out of the six nurses interviewed, four mentor nurses consider mentorship as knowledge contribution to the field of communication with people, four mentor nurses consider mentorship as stimulation for improving their own expertise, four mentor nurses would be willing to introduce new knowledge into practice and provide nursing care in accordance with the EBN. The knowledge gained form this research work may serve as a suggestion and aid for students planning to carry out clinical nursing practice at a clinic, for nurses who have been working or have been preparing to work as clinic mentor nurses, and certainly for all of those who wish to learn more on this issue and to understand the mentor nurse job.

The Thesis deals with the questions of psychosocial load at work for nurses and social workers. The Thesis is divided into two sections. The theoretical part deals with definitions of terms like caring professions, load and stress, then load at work and psychosocial load. There is also a brief characteristic of the professions of a nurse and a social worker. The aim of the empiric part was to find out on a selected sample of respondents (i.e. nurses and social workers) how the respondents perceive the character of their psychosocial load at work and whether they are at risk of burnout syndrome, to find out whether nurses or social workers perceive the psychosocial load more intensely and whether there is a difference in the risk of burnout syndrome between them. A quantitative questioning method and questionnaire technique were applied on data collection and processing in the research part of the Thesis. An anonymous questionnaire was used for the investigation. The questionnaire preparation was based on a questionnaire provided by my thesis guide. The original questionnaire was more extensive and was only designed for nurses, which was why I had to select suitable items and add some special items applicable on nurses as well as social workers. The questionnaire consisted mainly of closed questions where the respondents chose from five answers the one best corresponding with their own opinion. I set 3 hypotheses before starting the research itself. The questionnaire answers were processed both, manually by means of the stroke method and by a statistic programme SPSS. Segment and bar graphs in Microsoft Office Excel were used for graphical interpretation of the results. After evaluation of the questionnaire research results I found out that the previously set hypothesis H1 suggesting that nurses and social workers perceive various elements of their psychosocial load differently, was confirmed, hypothesis H2 suggesting that nurses are more loaded by the work with patients/clients than social workers was not confirmed, and hypothesis H3 suggesting that nurses are at higher risk of burnout syndrome than social workers was confirmed. The results of my thesis may serve to inform general public as well as professionals on the problems in question. They may also serve as a possible incentive for managerial staff to pay higher attention to the problems of psychosocial load at work among caring professions at individual medical care facilities. The results may also serve as a base for further studies and research in the field.

Requirements for changes in nursing care on the part of top management Abstract At present, nursing care has been experiencing a great progress. Implementation of the nursing process as a working method has been striven for. The educational system for non-medical workers has been changing. Nurses holding top managerial posts should have competence to lead and manage people effectively in the ever changing nursing environment. To acquire information necessary for achievement of the set goals, a quantitative research was employed. Within the framework of the quantitative research, the questioning method using a questionnaire was selected. The questionnaires concerned were sent to top managers among nurses and doctors working in medical centres all over the Czech Republic. The thesis had three objectives defined. First, to discover what prerequisites top managers miss to be able to implement the changes concerned in the area of nursing care. Second, to discover top managers´ opinions on the system of nursing care provision. Third, to identify differences between requirements for the nursing process method on the part of top managers {--} nurses and top managers {--} doctors. Based on these objectives, four hypotheses were formulated. The hypothesis no. I: The current situation does not allow top managers operating in health service to implement changes in nursing care in practice. This hypothesis has been confirmed. The hypothesis no. 2: Top managers do not require group nursing care as a prerequisite for the implementation of nursing care changes. This hypothesis has not been confirmed. The hypothesis no. III: Representatives of nurses in managerial posts promote the nursing process application as a prerequisite for changes concerning nursing care. This hypothesis has been confirmed. The hypothesis no. IV: Representatives of medicine doctors in managerial posts do not promote the nursing process application as a method of nurses´ work. This hypothesis has not been confirmed. As far as the results of this diploma thesis are concerned, we were trying to outline possible solutions of the issues concerning changes in nursing care. Top managers are recommended to stimulate critical thinking in their employees in the course of work in the nursing process. It is beneficial to improve communication on the managerial level in hospitals, and in addition, to obtain feedback from subordinates with respect to continuing education, to identify effectiveness and needs relating to education on the part of employees and to enable them to participate in the process of the respective changes implementation. To train function nurses in such changes management. To implement a programme aiming at continual quality improvement.

This work deals with the influence of a positive working environment in the work of nurses. At present, this issue is widely discussed, since there are large changes in the health sector. The problem concerns the lack of nurses, which is caused by nurses leaving to foreign countries to seek better working conditions. A lack of nurses is also caused by increasing demands on nurses, which is due to a reduced quality of health and nursing care. Furthermore, nurses are very badly paid. Another reason why nurses do not want to work in this profession is certainly the unhealthy working environment. An unhealthy environment reduces the performance of nurses, and often causes stress; long-term stress often has considerable consequences and nurses are forced to leave the workplace. If nurses are satisfied then patients are satisfied and the quality of care provided thus increases. This topic interested me because the issue of nurses working environment is currently very topical. I am also interested in how satisfied are nurses in the hospitals in which this research is carried out. In this research, I would like to learn how a positive work environment could be created for nurses. The research was conducted in hospitals in České Budějovice, Písek, Plzeň and Prague, through questionnaires and quantitative research. The research is based on a number of nurses working in these hospitals. The aim of this work is to see how a positive work environment affects nurses{\crq} work. The first hypothesis suggests that nurses need to perform their work a positive working environment. The second hypothesis should confirm that nurses need to perform their profession for a sufficient salary. The third hypothesis suggests that nurses need to perform their profession in a safe working environment. The fourth hypothesis should confirm that nurses welcome the opportunity of further education.

Abstract {--} Shaken baby syndrome problems and prevention from retrospective nurse point of view The dissertation objective on the theme {\clqq}Shaken baby syndrome problems and prevention from retrospective nurse point of view`` is to process an entire literature and outline the shaken baby syndrome problem. Further to find out the shaken baby syndrome knowledge at nurses and parents by way of analysis and questionnaires evaluation. The third aim of this thesis was to develop the simple educational material for the parents within this work. To meet these objectives the dissertation is divided into theoretical and practical parts. The theoretical one devotes to entire available literature processing related to shaken baby syndrome. The practical part focuses on the quantitative knowledge extent finding out at nurses and parents referring to shaken baby syndrome above all and concentrates on the parents education from nurse side, especially in the field of the baby cry as the main shaken baby syndrome initiator. The data of the quantitative research part have been learned by means of questionnaire disquisition. There were used two kinds of questionnaires, the first for nurses and the second one for parents and home nurses. Both of them were anonymous. The simple developed information material for parents concentrating mainly on correct ways of cry soothing related to shaken baby syndrome is the part of results. Three hypothesises have been set for work needs. Hypothesis 1 {\clqq}There are many sources of the professional literature concerning shaken baby syndrome in the Czech Republic`` hasn´t come true. Hypothesis 2 {\clqq}The parents and health workers knowledge about shaken baby syndrome is wanting`` has come true. Hypothesis 3 {\clqq}Shaken baby syndrome primary prevention doesn´t exist in the Czech Republic`` has also come true. The nurses and parents poor knowledge about the shaken baby syndrome was the important fact found out within research disquisition. With respect to serious consequences of shaken baby syndrome which can be sometime fatal for children there is a need to meet nurses this syndrome and enable them to be familiar with recognition and determination of the shaken baby syndrome risk factors both from the parents and children side. Thus this work could also serve as a source of more information about mentioned problems. The developed information material for parents could have another utilization during their care of child.

The theoretical part of the thesis introduces the current state of the issue. The fundamentals of management, the three basic lines of health managers and their functions and roles are described first. Another section is devoted to the specifics of nursing care in the intensive care unit. The second part is focused on qualified nurses, their qualification, duties and the role, factors of satisfaction and difficulties of the care for patients in the intensive care unit. The last part deals with problems occurring in exercise of the nursing profession and with the assistance of a manager in dealing with these problems. Five objectives were established. Objective 1: To identify what nurses working in intensive care units need to be satisfied in their work. Objective 2: To map the form of support to the nursing team in the ICU from the perspective of managers. Objective 3: To point out possibilities of increase in job satisfaction of nurses working in intensive care units. Objective 4: To identify motivational factors for nurses working in intensive care units. Objective 5: To determine if there are obstacles preventing managers from supporting the nursing team. Qualitative research was selected to collect the data and 6 research questions were established. Research question No.1: What do nurses working in ICU need to be satisfied in their profession? Research question No.2: Do nurses working in ICU perceive any difference in position of a nurse working in an ICU and a nurse working in a standard unit? Another question No.3: What are the means used by the management to support the nursing team in ICU? Question No. 4: What are the possibilities of increasing work satisfaction of nurses working in ICU? Question No. 5: Which specific motivational factors are involved in satisfaction of nurses working in ICU? Research question No. 6: Which obstacles prevent managers from supporting the nursing team? Non-standardized interviews were conducted with 8 ward nurses and 12 nurses working in shifts who were employed in intensive care units of surgical or internal departments. Answers to the established research questions were formed based on analysis of the results. Results can be provided to managers in health care facilities and to nurses working in intensive care units.

The main intention of this thesis was to monitor the activities of nurses as risk managers in selected healthcare facilities. The first objective was to map the current state of accreditation procedures in the Czech Republic, the number of accredited facilities and the types of accreditation. Another objective was to find out in which healthcare facilities there is a nurse as a risk manager or who has the responsibility of a risk manager in healthcare facilities. The third objective was to explore the activities of nurses - risk managers. To achieve these objectives, the following research questions were set: 1st What is the current state of accreditation procedures in the Czech Republic? 2nd In which accredited facilities there is a nurse - a risk manager? 3rd research question: What are the activities and roles of a nurse - a risk manager? (What activities nurses carry out in the performance of their duties; whether nurses feel a change in the provision of nursing care; which risks and incidents nurses encounter in their facilities and what are their solutions; what is the level of communication between the parties in the risk management process in a given facility; which benefits are seen in risk management). The research was conducted with respondents from those healthcare facilities that were willing to cooperate. The research conducted is a qualitative one. The respondents underwent interviews according to the structure of categorized questions. Subsequently, transcripts of the interviews were made as well as the analysis and categorization of the data was carried out and presented in tables under the framework analysis according to Ritchie and Spencer. The research revealed the answers to the research questions. In no of the facilities that have responded to the questions there is a nurse with the function of a risk manager. Activities within the risk management are taken over by staff at other positions, mostly quality managers, head nurses or auditors. Detailed proportion of these functions is clearly presented in the accompanying graphs. Research question 3 yielded a great number of responses. For example, nurses who have competence in risk management play mainly the roles of communicators, defenders, authors, auditors and mentors. In exercising their functions, they have observed changes, as compared with the past, in the responsibilities of nurses, patient activity, greater transparency, the quality and safety of the care provided. They describe in detail the risks and incidents which they have met at their workplaces, and how they have been solved. The respondents see the advantages of risk management in the fact that it is a good tool for defending not only patients but also nurses themselves; that it is a tool to increase responsibilities and activities of patients and to improve the quality and safety of the care provided. All the responses are clearly presented in tables and confronted with the knowledge derived from professional literature and our own experience. The results of the thesis can be provided to the healthcare facilities where the research has been carried out; it could be provided to competent institutions and also, in the form of an informative brochure, to nurses and other healthcare personnel. We would suggest a higher level of education about risk management potential. Our suggestions also include changes to legislation - powers, the establishment of clear procedures and rules, and the regulation of education in risk management so that implementation of this tool is unified and becomes accessible to all facilities.

Sepsis represents a serious medical, but also social problem. Hundreds of thousands of patients die from serious sepsis and septic shock every year. Patients with serious sepsis are treated at intensive care units and their treatment is long, costly and low efficient. These are the reasons why prevention of sepsis focused on prevention and effective treatment of nosocomial infections or timely solution of another problem, e.g. a shock is so much stressed. Nosocomial infections affect about 30 per cent of patients at intensive care units and may cause serious diseases, sepsis or even death. This thesis deals with the possibilities nurses have to influence sepsis, particularly by adherence to aseptic procedures and prevention of nosocomial infection, which might consequently develop in nosocomial sepsis. Combination of quantitative and qualitative methods was used for the research. There were two goals set for the quantitative research. 1. To find whether obstacles occur in adherence to proper aseptic procedures in nursing work as prevention of nosocomial infection occurrence and subsequent septic conditions in patients hospitalized at intensive medicine workplaces. 2. To map the weak points in adherence to proper aseptic procedures in nursing work in intensive care. The goals led to hypotheses H1 Obstacles obstructing thorough adherence to proper aseptic procedures in nursing work exist in intensive care. H2 Non-adherence to aseptic procedures occurs in nursing work at intensive medicine workplaces as a consequence of lack of time for particular interventions. The research sample consisted of nurses from the intensive care workplaces ARD and ICU from 8 hospitals. Questioning method through the questionnaire technique was used for data collection. 342 questionnaires were distributed in total. Hypothesis 1 was refuted, hypothesis 2 was refuted. We found that no obstacles obstructing adherence to proper aseptic methods occur, we mapped the weak points in adherence to proper aseptic procedures in nursing work in intensive care. There were two goals set for the qualitative research. GOAL 3 To find what measures preventing occurrence of nosocomial infection and subsequent septic conditions in patients hospitalized at intensive medicine workplaces are taken by department managements. GOAL 4 To find out how department management deals with possible occurrence of nosocomial infection and subsequent septic conditions in patients hospitalized at intensive medicine workplaces. The following research questions were set. 1. What are the measures preventing occurrence of nosocomial infection and subsequent septic conditions in patients hospitalized at intensive medicine workplaces taken by department managements? 2. How does department management solve possible occurrence of nosocomial infection and subsequent septic conditions in patients hospitalized at intensive medicine workplaces? The research sample consisted of 5 departmental nurses and 5 head nurses from intensive care workplaces from the same hospitals where the quantitative research took place. The research was performed by semi-standardized interview. The research questions were answered. A manual for nurses called ?Recommendation for nurses in prevention of nosocomial infection and nosocomial sepsis not only at intensive care units? was elaborated upon study of these issues and the performed research. A thought map for department management illustrating prevention and solution of nosocomial infection and nosocomial sepsis was also elaborated. Both the document and the research results will be provided particularly to the managements of the hospitals that took part in our research. The thesis may also be helpful to nurses, students and other interested people to gain overall insight into the issue.

Occupation of a general nurse belongs to demanding jobs in terms of professional preparation and performance. A nurse is expected to cope with professional activity, working with modern technology, administrative work, to bear the physical and mental load of her profession, to be able to influence and direct patients? feelings and behaviour and finally to be able to cope with professional as well as family problems she is faced to. All this is often dealt with in continuous operation on shift basis at various specialized workplaces. Questions how nurses working at a cardiac surgery department are satisfied or dissatisfied at their jobs, how the work experience length affects their satisfaction, whether possible discontent among nurses may affect quality of the nursing services provided by them and how the hospital management reduces the factors of discontent, became the subject of my thesis. The research was performed at the IKEM in Prague. Quantitative as well as qualitative research methods were used for data collection when mapping the problems in question. The quantitative part involved a questionnaire both, for general nurses working at the cardiac surgery department, aimed at investigation into the discontent factors involved in their occupation, and for the patients undertaking treatment at the cardiac surgery department, to examine their satisfaction with the nursing care. Analysis of the collected data was then performed. An interview with representatives of the hospital line, middle and top managements was the instrument of the qualitative research. It was focused on the question how they proceed in elimination or reduction the discontent factors. The following facts were found out by the quantitative research. Increased physical and mental load, non-cooperating patients and care about more patients at the same time, extensive administration related to patient care, insufficient remuneration, lack of communication from doctors and superiors, lack of auxiliary staff, projection of occupation to private life or the problem of sleeping after a night shift are the most frequent discontent factors. Despite the above negative factors nurses are satisfied with their jobs regardless the length of experience. The indentified factors of discontent do not affect quality of the care provided by the nurses. The qualitative research results show that personal talks, active interviews and direct communication from the staff are the most frequent methods the management uses to map staff satisfaction. The management representative is able to work herself on elimination or reduction of the discovered factors of discontent within her competences, which happens most often. She may also cooperate with the chief nurses or ward sisters. Unless she is able to solve a problem, it is passed to the authorized persons competent to deal with it (health care manager, social-legal department, HR department). The hospital director is also informed on the most serious cases. The management hardly ever cooperates with physicians on elimination or reduction of the discontent factors. The most important aspect of solving the problem of discontent factors is its subject, which affects the solution method, whether it is to be dealt with by an individual or the whole team. They inform the head physicians or the ward chief consultant on serious problems. The course of the problem solution is communicated to the employees by the ward sisters or chief nurses personally, orally.The goals of the thesis have been met, the set hypotheses have been refuted, and the research questions have been answered.